New Technology Means Greater Precision And Comfort

For Invisalign Orthodontics Patients

By Nancy K. Crevier

A perfect smile is about to become more perfect for orthodontist Dr Aaron Gilman’s patients at Dental Associates of Newtown. On Tuesday, November 8, Dr Gilman accepted shipment on the iTero digital scanner, a computerized system that will eliminate the need for the traditional cast mold of the teeth used by dentists to design a plan of treatment for orthodontics.

The new technology, only recently available through Invisalign, creator of the clear plastic templates used to adjust dental bites without old-fashioned wires and bands, allows Dr Gilman and staff to digitally scan the teeth using a special laser light wand that feeds light and shadow into the computer. The software runs mathematical equations, interpreting the light and shadows as to where the teeth are, and a perfect model of the mouth appears on the screen.

“The computer essentially does the thinking for us. We can look at and study this model, and manipulate it,” said Dr Gilman. “The efficiency is one aspect of this technology, but the precision that it allows is really what drew me to it,” he said.

Dr Gilman first read about the iTero digital scanner in dental journals earlier this year, and invited a company representative to give a presentation at the office. “After we evaluated it, I decided to purchase it. We’ll get a better product from Invisalign, because we are now providing them with better information, and that means our patients will get better results,” he said.

Prior to November 8, Dr Gilman’s patients preparing for orthodontics using Invisalign had to have an impression of their teeth made, in order for the company to create the series of clear plastic templates used to move the teeth. “The molds were good, but inaccuracies can occur. To make a mold, we are mixing a powder and water, and if the mix is not exactly right, there will be a slight imperfection to the mold,” Dr Gilman said. Additionally, the materials used to make the stone cast of the mold can also have variations that result in a less than perfect final product. In some instances, the mold is inaccurate enough that the patient must be called back to the office and a new impression made. That results in additional time for both the doctor and the patient. For younger patients, especially, said Dr Gilman, making the impression causes a gag reflex due to the texture and quantity of substance that must be used to make the mold. Until now, that technology was the best available, though, and orthodontists had to work with it.

With the iTero scanner, Dr Gilman said, patients are not subjected to any unpleasant experiences to obtain a precise model of their teeth, other than a slight oral dryness from having air blown onto the teeth and having to keep the mouth open for the 15–20 minutes it takes to get the digital impression. The iTero scanner, unlike some of the other digital scanners available to dentists, does not even require the use of a powder on the teeth, he said.

The process uses only light to scan the teeth, Dr Gilman emphasized, “Just like the light in your laser pen. There is no radiation, it is not an x-ray. It is safe for both the technician and the patient.”

Patients are provided with large dark glasses to wear during the process, but only because the flashes from the light as the wand scans the mouth can be very bright. It is not mandatory, however, that patients wears them if the light does not bother them, Dr Gilman said.

There is a large learning curve for using the iTero digital scanner, admitted Dr Gilman. “It’s a new way of thinking, to understand the computer image, and how to read it on the screen. It is very different from holding a stone model in your hand,” he said.

Two technicians from Invisalign were in the office beginning November 8, for three days, for staff training, said Dr Gilman. “It’s great, so far. This will become easier for us each time we use it, and I expect that we will soon be able to do a scan more quickly than we could ever make an impression. We’re always learning in the field of dentistry, every day,” he said.

Once Dr Gilman reads the results of the scan, he sends the prescription and goals of treatment, along with the images, to Invisalign. Using a process called stereolithography, a manufacturing process using liquid resin and UV laser, an exact plastic replica of the teeth at each stage of treatment, known as a retainer, is produced for the patient.

“This is the only medical device company that makes a custom-made device,” noted Dr Gilman.

The iTero digital scanner at Dental Associates in Newtown is also the first one in the area. The portable scanner will move between the four Dental Associate offices in the state, he added, so that all Dental Associate patients will have access to what he sees as a superior means of determining the best Invisalign treatment.

“There will always be a place for the cast molds,” said Dr Gilman. While the majority of his patients opt for the wireless, clear Invisalign product, from children through adults, there are some patients for whom Invisalign is not the best means for orthodontic treatment. “We still need the cast molds for the palate expanders [that many children have before braces],” he said, but he foresees a not too distant future in which the new technology will even be able to create virtual images for expanders, too.

The iTero digital scanner is not an inexpensive tool, said Dr Gilman, but he is happy to invest in it to provide a better product to his patients. “There is no additional cost to the patient,” he said. “It is the cost of creating a better smile for my patients by using a new technology that is here, and I’m happy to do that,” Dr Gilman said. “I think if something is being done, it should be done right. This kind of accuracy means greater precision. We will have a better treatment, because it is more accurate [than the cast molds].”